Iowa
Bible
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Please mail completed forms
to Stefan Johnson c/o |
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Name: |
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Address: |
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Phone Number: |
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Email Address: |
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Circle choice of
camp Junior
Senior |
Medical History
Are there any medical issues that may affect your ability to perform in any camp activities? Please explain.
Do you have any allergies to foods, insects, medications etc? Please list
Are you currently taking any Prescription medicines? Please list.
Are you now or have you in the last 10 years used any recreational drugs (including under-aged drinking)? If yes please explain.
General Questions:
If you are a student or are entering college in the fall, what school are you attending?
What is your marital status? (Circle one) single married
Have you ever been divorced? (Circle one) yes no
Have you previously counseled at any Christian camps? If yes, which camp?
What is your counseling preference? ___ Junior camp (age 9-11) ___Senior camp (age 12-18) ___ No Preference
All counselors work in the camp program as well as counseling. Do you have special talents tat could be used in the programs such as land sports, crafts, nature craft, waterfront skills (WSI or Certified lifeguard), music talent etc? Please specify.
Where are you currently attending church?
How long have you attended this church?
Are you in regular attendance at any of the following? (Circle all that apply)
Worship meeting teaching/preaching meeting Prayer meeting
Please name one pastoral reference from your church whom we may contact. Phone #
In a few sentences please define the Gospel.
On a separate sheet of paper, write your personal testimony of faith in Christ. Tell how and when you were saved. Include verses from the Bible to support the fact you have eternal life. This only needs to be done one time. We will keep your testimony on file for the future camp years.
Please Carefully Read the
If you have any reservations or questions regarding any part of this application including agreeing to the statement of faith, please contact Stefan Johnson to discuss, (stefanjohnson@lycos.com), or phone number 712-243-1371.
Certification
I hereby certify that I have read and filled out the above questions to the best of my knowledge. I agree to serve at the camp under the authority and supervision of the camp director. I agree to follow all camp rules and to fulfill my responsibilities as a counselor including chapel attendance, devotionals preparation, and scheduled recreation assignments. I understand it is a privilege to serve Christ and the campers at I.B.C.
In case of surgical or medical emergency, I hereby give permission to the physician selected by the camp director or leader to hospitalize and to secure all proper treatment for the applicant named above including medication, anesthesia, and surgery. Signed and dated(also list emergency contact with address and phone number)